目的:本研究旨在评估多普勒超声心动图在评估左心室舒张功能中的应用,系统性红斑狼疮(SLE)患者的预后。
方法:选择286例SLE患者以及100例年龄和性别相匹配的健康人进行体检。收集临床基线特征。测量并分析了各种多普勒超声心动图参数,包括左心室后壁厚度(LVPWT),室间隔直径(IVSD),左心室质量(LVM),LVM指数(LVMI),和其他人。
结果:与对照组相比,SLE患者表现出显著较高水平的C反应蛋白和较低水平的补体(C)3和C4(p<.001)。多普勒超声心动图参数显示SLE患者与健康对照组之间存在显着差异,包括增加的LVPWT,IVSD,LVM,LVMI,A峰,PWI+Tei,E/E\',TDI-Tei,并减少e'和E/A(p<.001)。亚组分析表明,SLE活动度较高的患者和发生心血管事件的患者心室舒张功能障碍更严重。相关分析显示PWI+Tei呈正相关,TDI-Tei,和GLS伴SLE活动和心血管事件(p<0.01)。多因素logistic回归分析确定LVMI,PWI+Tei,TDI-Tei,和GLS是心血管事件的重要预测因子(p<0.05)。
结论:多普勒超声心动图是早期诊断SLE患者左心室舒张功能不全的重要工具。关键超声心动图参数,包括LVMI,PWI+Tei,TDI-Tei,GLS,能有效预测心血管事件,强调对这些患者进行综合心功能评估的重要性。
OBJECTIVE: This study aimed to assess the utility of Doppler echocardiography in evaluating left ventricular diastolic function, and prognosis in patients with systemic lupus erythematosus (SLE).
METHODS: A total of 286 SLE patients were selected along with 100 age- and gender-matched healthy individuals who underwent physical examinations. Clinical baseline characteristics were collected. Various Doppler echocardiographic parameters were measured and analyzed, including left ventricular posterior wall thickness (LVPWT), interventricular septal diameter (IVSD), left ventricular mass (LVM), LVM index (LVMI), and others.
RESULTS: Compared to the control group, SLE patients exhibited significantly higher levels of C-reactive protein and lower levels of complement (C) 3 and C4 (p < .001). Doppler echocardiographic parameters showed significant differences between SLE patients and healthy controls, including increased LVPWT, IVSD, LVM, LVMI, peak A, PWI + Tei, E/e\', TDI-Tei, and decreased e\' and E/A (p < .001). Subgroup analyses indicated more severe ventricular diastolic dysfunction in patients with higher SLE activity and those who experienced cardiovascular events. Correlation analysis revealed positive associations of PWI + Tei, TDI-Tei, and GLS with SLE activity and cardiovascular events (p < .01). Multivariate logistic regression analysis identified LVMI, PWI + Tei, TDI-Tei, and GLS as significant predictors of cardiovascular events (p < .05).
CONCLUSIONS: Doppler echocardiography is a valuable tool for the early diagnosis of left ventricular diastolic dysfunction in SLE patients. Key echocardiographic parameters, including LVMI, PWI + Tei, TDI-Tei, and GLS, are effective in predicting cardiovascular events, underscoring the importance of comprehensive cardiac function assessments in these patients.